Bicycle Rental Program Registration Form The Bicycle Rental Program is designed to better serve UNB students who would like to explore the city of Fredericton and the surrounding areas. The program is not intended to provide student’s day‐to‐day transportation from his/her residence to the university, but rather a means of promoting outdoor physical activity and experiencing the community. This program is made available for UNB students ONLY. St. Thomas University students, faculty/staff and general public are not eligible for the program. First Name: ___________________________ Last Name: __________________________ Student ID: ___________________________ Faculty: _____________________________ E‐Mail: _______________________________ Phone Number: ______________________ Payment: Debit □ Cash □ Credit Card □ Cheque □ (payable to UNB) Signature: ____________________________ Date: _______________________________ I, the undersigned, recognize that participation in the referenced activity is strictly voluntary and that such participation does not in any manner establish an employer‐employee or an agency relationship with the University of New Brunswick. I, the undersigned, in consideration of the request and permission to participate in the referenced activity hereby assume full responsibility for all risk of injury or loss which may result from my participation in the activity and hereby agree to hold harmless, release and forever discharge the Sponsor and the Regents of the University of New Brunswick, their officers, agents, and employees from any and all claims and demands whatsoever which the undersigned or any representative of the undersigned, may have by reason of any accident, illness, injury to or death of any person or persons, or damage to or loss or destruction of any property arising or resulting directly or indirectly from participation in the aforementioned and occurring during said participation or any time subsequent thereto, save and except that the above provisions shall not be applicable to injury to or death of person, or damage to or loss of property arising out of the negligent or intentional acts of the Sponsor or the Regents of the University of New Brunswick. The terms of this release will serve as a release and assumption of risk for my heirs, executors and administrators for all of my family members. I agree and acknowledge that some activities may be of a hazardous nature and /or include physical and/or strenuous exercise or activity and, understanding this, I state that to the best of my knowledge I have no medical, physical or mental health conditions that would hinder or prevent my active participation in the referenced activity. PLEASE NOTE: It is strongly recommended that each participant maintain some type of accident medical insurance for his/her own protection.
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